As an addiction professional and licensed mental health professional, I have worked with hundreds of individuals who have suffered from various addictive disorders. I have been entrenched in their stories and their closest confident, as times. One thing I have always strived to do for my clients is to create a safe space, without judgement, for clients to share their deepest most vulnerable thoughts pertaining to their addiction and why they use. When I worked in a clinic specifically for individuals with opioid use disorder, I encountered plenty different folks. Some being your stereotypical homeless individuals to your average working class husband/father, to your highly ambitious mother running her own business. After the many stories, you start to see correlations and how they all connect to one another. Though each individual is unique, they were not dealing with a unique problem. Actually, it was much more common than they realized. There’s a lot of stigma surrounding opioid use. Surprisingly enough, MOST of my clients who became addicted to opioids began with an injury. They had gone through a surgery or experienced some serious debilitating pain that was impossible to cope with. They were prescribed pain medication. They used it consistently and then noticed one day when they ran out, they became very ill, while experiencing symptoms such as: shaking, tremors, cold sweats, vomiting, upset stomach and fever. The shocking part came when such individuals were not seeking to become addicted. The only problem they were numbing was their physical pain because let’s face it, we want a remedy for pain. Few are willing to embrace pain and feel it completely. Some individuals realized the problem and required weening off of medications. Some, however, experienced such dependency that the easiest way out was purchasing medications off the street and later graduating to smoking and injecting Heroin. But what separates someone from being able to take prescribed opioid medications without being physically dependent? Let’s say you have a family of 5: Mother, father, 3 kids. The mother has been abusing various substances since she was 15. The father is a high functioning work-aholic and alcoholic during his evenings and days off. 2/3 siblings develop a substance use disorder. If genetics rule all, then all children would have developed substance use disorders, which scientifically, this is not the case. If we look at environmental factors such as, early exposure to substance abuse(within the family or social circle), poor support system, limited parental guidance/supervision, exposure to abuse and trauma, then the environmental factors will create susceptibility to substance abuse. In cases where there is a family history of substance abuse (notice substance ABUSE, not substance use) and exposure to environmental risk factors, the chances of individuals developing substance use disorders are predictable.
However, you still have the wild card that even though one may have family history or substance abuse and exposure to risk factors, they do not develop a substance use disorder. This individual will drink but not want the entire bottle. They don’t feel the need to keep going. They are actually not attracted to drunken behaviors and hangovers. This individual may be prescribed opioids or Benzodiazepines and never feel the impulse to keep taking more. With that being said, what protects this individual for ending up like their siblings or parents? What protective factor has science not identified?
This is the great debate in the field of substance abuse. There has not been definitive research to answer this question, although many have theorized.
Some professionals say the answer is resiliency. That certain individuals develop a resiliency and instead of developing a substance use disorder, they turn their negative experiences into fuel to create a better and more positive experience in their future. Is resiliency biological? Is it psychological? Or is this strength something that comes from within a human’s soul? What role does our soul, our own spirituality, play when it comes to susceptibility to addiction?
Please share what you think in the comments below!
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